Abstract:

Objective

Scholars both domestically and internationally have proposed different variations of the celiac axis （CA） and various typing methods.However， each method has its own advantages and disadvantages， making it challenging to establish a unified typing system.In this study， the anatomical variations of each branch of the CA were observed using multi-slice CT angiography.A new CA classification was proposed， and the clinical implications of this novel classification in treatment was investigated.

Methods

The clinical data of 747 patients who underwent abdominal multi-slice CT angiography for vascular imaging from August 2020 to December 2022 were retrospectively analyzed.The selected threedimensional reconstruction images of the CA were observed to analyze and summarize the variations of its branches.Data statistics were conducted on the various variations， and a new classification method for CA was proposed.

Results

A total of 747 samples were analyzed using the new classification method.This classification system categorizes CA into three main types： I， II， and III.Each main type further consists of two subtypes， resulting in a total of six subtypes.These subtypes are Ia， Ib， IIa， IIb， IIIa， and IIIb.Among the samples， there were 696 cases of type I， which accounted for 93.2% of the total （696/747）.Type Ia comprised 555 cases， representing 74.3% （555/747）， with 369 males and 186 females.Type Ib accounted for 141 cases， making up 18.9% （141/747）， with 95 males and 46 females.Type II had 50 cases， corresponding to 6.7% （50/747）.Type IIa had 46 cases， accounting for 6.2% （46/747）， including 34 males and 12 females.Type IIb had 4 cases， making up 0.5% （4/747）， with 3 males and 1 female.There was only 1 case of type III， representing 0.1% （1/747）.This case was a male.There were no cases of type IIIa， but there was 1 case of type IIIb， accounting for 0.1% （1/747）.The extra arteries with the highest proportion in the sample were the inferior phrenic artery （IPA）， dorsal pancreatic artery （DPA）， and superior mesenteric artery （SMA）.

Conclusion

The CA exhibits high variation.The new celiac axis classification， based on multi-slice spiral CT， is straightforward and easy to remember， providing valuable guidance for clinical surgery.

Key words: Celiac axis, Vascular variation, New classification, CTA